Læknablaðið - 15.11.1982, Blaðsíða 4

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NÝR DOKTOR í LÆKNISFRÆÐI - KRISTJÁN SIGURÐSSON
Kristján Sigurðsson varði hinn 3. september sl.
doktorsritgerð sína við Onkologiska Kliniken,
Lasarettet í Lundi í Svípjóð. Heiti hennar er
Malignant Epithelial Ovarian Tumours. A
study of Prognostic Factors and the Effects of
Combined Treatments. Hér fer á eftir útdrátt-
ur úr ritgerð Kristjáns Sigurðssonar:
Six-hundred and twenty-two women with
malignant epithelial tumour have been studi-
ed. Of these, 494 women were treated at the
Department of Oncology in Lund during 1974-
1978 and 128 women treated at this and seven
other, Oncologic Departments in Sweden
during 1978-1980. These women were inclu-
ded in studies analyzing the prognostic fac-
tors, and in prospective randomized trials
comparing the effects on survival and opera-
bility of: a) chemotherápy, radiotherapy or the
combination of both in Stages I through III,
and b) radiotherapy, single-drug and combina-
tion chemotherapy in advanced Stage III.
Twenty patients were included in a trial
comparing the drug-sensitivity in vitro with
the in vivo treatment results.
The stage of tumour dissemination, the
tumour grade and the size of the residual
tumour after surgery had the greatest progno-
stic significance. Stages I through Ila can be
divided into three prognostic groups accord-
ing to the tumour grade. Well differentiated,
early Stage Ia tumours do not seem to benefit
from postoperative treatment. Single-drug
chemotherapy seems to be sufficient as addi-
tional treatment in well differentiated, advanc-
ed Stage Ia and Stages Ib through Ila tumours
and all moderately differentiated tumours in
Stages I through Ila. All poorly differentiated
tumours in Stages I and Ila need more
aggressive treatment. Stages Ilb through III
can be divided into three prognostic groups,
depending on the size of the residual tumour
and the tumour grade. Patients with no or
small residual tumours, well or moderately
diffferentiated, had the best prognosis, while
patients with poorly differentiated tumours, or
large residual tumours, irrespective of grade,
had the poorest prognosis. Radiotherapy gave
acceptable results on well or moderately
differentiated tumours with no or small resi-
dual tumours. In large residual tumours com-
bination chemotherapy had significantly bet-
ter effect on survival than single-drug chemo-
therapy or radiotherapy, irrespective of grade.
Combination chemotherapy and radiother-
apy had the same effect on (re)-operability
and can be used as preoperative treatment in
order to increase the operability. Unilateral
salpingo-oophorectomy is indicated in young
women with well or moderately differentiated
Stage Ia tumours. Hysterectomy and oment-
ectomy are only indicated if radical surgery or
small residual tumour can thereby by ac-
complished.
In 80 % (16/20) of the patients there was a
correlation between the drug sensitivity re-
sults in vitro and the treatment results in vivo.